preventable causes of premature death in the United States.
- Public health action by policy makers to eliminate exposure to environmental tobacco smoke
(ETS) is long overdue. A total ban on smoking is preferred on various grounds. Policy makers
should pursue all strategies that would help accomplish that goal, including education legislation,
Regulation, litigation and enforcement of existing laws. - Government of India is a party to 16 or so resolutions adopted by the World Health
Organization since the 1970s, particularly the one adopted in 1986, which urged member-
countries to formulate a comprehensive national tobacco control strategy.
It was envisaged that the strategy would contain measures:
(i) to ensure effective protection to non-smokers from involuntary exposure to tobacco smoke;
(ii) to promote abstention from the use of tobacco to protect children and young people from
becoming addicted;
(iii) to ensure that a good example is set on all health-related premises by all health personnel;
(iv) to progressively eliminate all incentives which maintain and promote the use of tobacco;
(v) to prescribe statutory health warnings on cigarette packets and the containers of all types of
tobacco products;
(vi) to establish programmes of education and public information on tobacco and health issues
with the active involvement of health professionals and media;
(vii) to monitor trends in smoking and other forms of tobacco use, tobacco-related diseases and
effectiveness of national smoking control action;
(viii) to promote viable economic 'alternatives to tobacco production trade and taxation; and
(ix) to establish a national focal point to stimulate, support and coordinate all these activities.
Despite the fact that India is a signatory to these resolutions it is saddening to note that no
significant follow-up action has been taken except banning smoking in public places and public
transport and printing a statutory warning on cigarette packets. Even here, the action has been
half-hearted with the ban on smoking in public places confined to Delhi and a few other cities and
the statutory warning being followed more as a ritual and printed in such small letters that the
consumer hardly notices it. Advertisement in the government controlled mass media has been
prohibited, but it continues unabated in the print media and private television channels. The
Government's lip-service is reflected in the absence of any mention about the hazards of tobacco
in the Health Ministry's Annual Report. Except on the occasion of the "World No Tobacco Day"
once a year, there has been no sustained campaign to counter the promotional campaign of
tobacco and highlight the toll tobacco use takes.
- Every year, 1 million tobacco-related deaths take place in India. An estimated 65 per cent of
men use tobacco, and in some parts a large proportion of women chew tobacco and bidies. About
33 per cent of all cancers are caused by tobacco, About 50 per cent of all cancers among men and
25 per cent among women are tobacco related. The number of cases of avoidable tobacco-related
cancers of the upper alimentary and respiratory tracts, coronary heart disease and chronic
obstructive pulmonary disease (COPD) has been estimated at 2,000,000 every year. Many still-
births low birth infants and pre-natal mortality have been reported among female chewers. - Tobacco kills 50 per cent of its regular users within 40 years. Apart from these direct health
implications of tobacco use the hazards faced by those engaged in the plucking and curing of
tobacco leaves have been highlighted by researchers of the Ahmedabad-based National Institute
of Occupational Health. The hands of the workers get affected by the chemicals in tobacco and
sickness is caused when nicotine gets absorbed into the body through the skin. The symptoms are
head-ache. nausea and vomiting, All these well-documented findings are available with the State